Blood pressure in relation to frailty in older adults : a population‐based study

Anker, Daniela (Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland) ; Santos‐Eggimann, Brigitte (Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland) ; Zwahlen, Marcel (Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland) ; Santschi, Valérie (Institut et Haute Ecole de la Santé La Source, HES-SO Haute école spécialisée de Suisse occidentale) ; Rodondi, Nicolas (Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland; Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland) ; Wolfson, Christina (Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Quebec, Canada) ; Chiolero, Arnaud (Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland; Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Quebec, Canada; Population Health Laboratory, Department of Community Health, University of Fribourg, Fribourg, Switzerland)

In frail older adults, low blood pressure (BP) might be associated with worse health outcomes and hypertension management in this population is highly debated. Using data from a population‐based study of older adults, we assessed the association be‐ tween frailty and BP. We used data collected between 2014 and 2016 from 3157 participants aged between 67 and 80 years in the Lausanne cohort Lc65+. BP was measured three times at one visit, and frailty status was assessed based on Fried's phenotype model. We analyzed the cross‐sectional association between BP and frailty by computing mean systolic and diastolic BP stratified by sex, age, and frailty and by fitting regression models. The average age of the participants was 73.3 (standard deviation [SD]: 4.1) years, and 59.1% were women. 34.1% were pre‐frail, and 3.3% were frail. Mean BP was 135.1/76.3 mm Hg (SD 18.5/11.0). Age‐ and sex‐ adjusted systolic BP was on average lower by 2.8 mm Hg (95% confidence interval [CI]: 1.4‐4.2) and 6.7 mm Hg (95% CI: 3.2‐10.3) among pre‐frail and frail compared to non‐frail participants. Similar differences in mean diastolic BP across frailty sta‐ tus were found. Upon adjustment for antihypertensive treatment, the associations between frailty status and BP did not change substantially. Frail individuals had a substantially lower BP compared with non‐frail older adults. Because low BP could be detrimental among frail older patients, our findings raise questions about hyper‐ tension management in this population and stress the need for additional evidence.


Keywords:
Article Type:
scientifique
Faculty:
Santé
School:
La Source
Institute:
Secteur Recherche et Développement (Ra&D) de l'Institut et Haute Ecole de la Santé La Source
Subject(s):
Santé
Date:
2019-01
Pagination:
10 p.
Published in:
The Journal of Clinical Hypertension
Numeration (vol. no.):
2019, vol. 21, no. 12, pp. 1895-1904
DOI:
ISSN:
1524-6175
Appears in Collection:

Note: The status of this file is: restricted


 Record created 2020-01-06, last modified 2020-02-11

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